Skip to main content

Main menu

  • Content
    • Current Issue
    • Advance Access
    • Archive
    • Supplements
    • Special Collections
    • Topic Collections
  • For Authors
    • Instructions for Authors
    • Tips for Writing About Programs in GHSP
      • Local Voices Webinar
      • Connecting Creators and Users of Knowledge
    • Submit Manuscript
    • Publish a Supplement
    • Promote Your Article
    • Resources for Writing Journal Articles
  • About
    • About GHSP
    • Editorial Team
    • Advisory Board
    • FAQs
    • Instructions for Reviewers

User menu

  • My Alerts

Search

  • Advanced search
Global Health: Science and Practice
  • My Alerts

Global Health: Science and Practice

Dedicated to what works in global health programs

Advanced Search

  • Content
    • Current Issue
    • Advance Access
    • Archive
    • Supplements
    • Special Collections
    • Topic Collections
  • For Authors
    • Instructions for Authors
    • Tips for Writing About Programs in GHSP
    • Submit Manuscript
    • Publish a Supplement
    • Promote Your Article
    • Resources for Writing Journal Articles
  • About
    • About GHSP
    • Editorial Team
    • Advisory Board
    • FAQs
    • Instructions for Reviewers
  • Alerts
  • Find GHSP on LinkedIn
  • Visit GHSP on Facebook
  • RSS
EDITORIAL
Open Access

Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative

Colin Baynes, Lola Adedokun, John Koku Awoonor-Williams and Lisa R. Hirschhorn
Global Health: Science and Practice September 2022, 10(Supplement 1):e2200390; https://doi.org/10.9745/GHSP-D-22-00390
Colin Baynes
aDepartment of Global Health, University of Washington, Seattle, WA, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: cbaynes@uw.edu
Lola Adedokun
bFormerly of the Doris Duke Charitable Foundation, New York, NY, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John Koku Awoonor-Williams
cFormerly of the Department of Policy, Planning, Monitoring and Evaluation, Ghana Health Service Accra, Ghana.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lisa R. Hirschhorn
dFeinberg School of Medicine, Northwestern University, Chicago, IL, USA.
eRyan Family Center for Global Primary Care, Havey Institute for Global Health, Northwestern University, Chicago, IL, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
PreviousNext
  • Article
  • Info & Metrics
  • Comments
  • PDF
Loading

INTRODUCTION

Universal health coverage (UHC) can be achieved by strengthening the implementation of public health and clinical policies and programs in health systems.1 For decades, research has established a substantial evidence base on the primary health care interventions that policies should emphasize. Conversely, the need for replicable knowledge on how to transform evidence-based policies into effective large-scale action has received less attention.2 As a corollary, efforts to advance the use of evidence-based interventions (EBIs) in global health are replete with experiences of lengthy delays between the recognition of EBIs and their equitable and high-quality delivery throughout health systems and their integration into policies, which is needed to ensure sustainability.3,4 Demonstrating ways to bridge the gap between the promulgation of sound health policy and changes in real-world practice, including how systems support these changes, is essential to achieving UHC.5 The articles in this Global Health: Science and Practice supplement showcase the experience of action research projects led by policy-implementation-academic partnerships that aimed to address this gap in 3 sub-Saharan African countries: Ethiopia, Ghana, and Mozambique.

Implementation leaders can maximize the impact of EBI if they identify and implement delivery strategies that are contextually appropriate, driven by data, and feasible to use and spread within health systems. Moreover, they should include measures to ensure equity and quality of care.6 As the articles in this GHSP supplement discuss, when these strategies are combined with work to generate actionable evidence and facilitate knowledge translation, then bridging the “know-do” gap becomes increasingly attainable.7 For example, in Mozambique, the combination of an audit and feedback intervention led by district health officials with research capacity strengthening of health workers led by local research groups led to improvements in maternal and newborn health EBI implementation in public health facilities.8 Embedded implementation research (EIR) is a promising tool in this endeavor. EIR integrates scientific inquiry within practice through decision maker–led research partnerships whereby knowledge “users” (i.e., policy makers, managers, implementers) are also knowledge “producers.”9 As such, decision makers take a prominent role throughout the research process—identifying needs for research and specific implementation problems, selecting methodology, interpreting findings, and stimulating the use of evidence in programmatic decisions.10

AHI’S HISTORY OF LEVERAGING EIR TO STRENGTHEN POLICY AND PRACTICE

Since 2009, the African Health Initiative (AHI) of the Doris Duke Charitable Foundation has funded partnerships between (1) ministries of health that led the integration of research in primary health care policy implementation, (2) embedded scientists from local research institutions that conducted EIR from within primary health care systems, and (3) local-level implementation teams that were involved in the design of delivery strategies and use of data to improve how they work. The partnership structure aimed to enable projects to leverage EIR as a tool to strengthen primary health care delivery and demonstrate ways to maximize the impact of EIR by incorporating research capacity strengthening and knowledge translation support in policy implementation processes. The AHI supported partnerships in 6 countries in 2 phases of grants: Ghana, Mozambique, Rwanda, Tanzania, and Zambia in phase 1 (2009–2015), and Ghana, Ethiopia, and Mozambique in phase 2 (2016–2022), each with grants of US$8–US$13 million. In addition, each AHI partnership included a U.S.-based university with a history of supporting health development and building research capacity in sub-Saharan Africa.

In 2013, the partnership teams co-authored a journal supplement that described their individual intervention designs and cross-cutting components, which included improving data and service delivery quality and strengthening health information systems, and a common evaluation framework that was based on the World Health Organization’s 6 building blocks for health systems strengthening.11–15 By 2015, key lessons emerged that were useful for informing the replication and scale of delivery strategies formulated and evaluated by the AHI phase 1 partnerships. In Ghana, the AHI project informed the Ministry of Health’s strategy on how to accelerate the pace of scaling up national primary health care policy.16 The Mozambican partnership strengthened district-level management capacities in the context of decentralization.17 In Rwanda, the project developed guidelines on quality improvement with a focus on newborns.18 The Tanzanian partnership designed and tested the impact of introducing a national community health worker program.19

These achievements were disseminated in a second AHI supplement, in which authors from the 5 teams harvested new knowledge and synthesized findings into lessons that were generalizable across partnerships. Cross-cutting effective strategies used in 2 or more countries included mentoring to improve clinical service quality and systems, improving data quality, using data for quality improvement, measuring health systems strengthening, targeting neonatal mortality, and building research capacity.20–26 The AHI phase 2, which focused on adapting and evaluating models to replicate effective UHC strategies from phase 1, began in 2017 when the Doris Duke Charitable Foundation granted additional funding to the teams from Ghana and Mozambique and granted new funding to a partnership in Ethiopia. The grants were also designed to strengthen the absorptive capacities of health systems to use evidence and learn about and sustain conditions that are conducive to improving primary health care performance and scaling up.

HELPING PRIMARY HEALTH CARE SYSTEMS BRIDGE THE KNOW-DO GAP

This third supplement highlights experiences using EIR to strengthen primary health care systems. For example, authors from Ghana demonstrate how embedding research at different stages of the policy making process guided the initial design of the national Community-based Health Planning and Services program and, subsequently, how EIR-informed strategy that district implementation teams have used to accelerate the program’s scale-up.27 Altogether, these lessons make clear that helping health systems to acquire and foster the spread of skills to practice EIR can help fill the know-do gap.

The lessons in this supplement make clear that helping health systems to acquire and foster the spread of skills to practice EIR can help fill the know-do gap.

The articles describe the key learnings that emerged by the penultimate year of the AHI phase 2 in Ethiopia, Ghana, and Mozambique. As in the previously published supplements, the articles showcase cross-project learning that arose from collaborative working groups, which comprised AHI-partnership representatives from Ethiopia, Ghana, and Mozambique. The supplement also includes collaborative working group articles on 3 themes across the 3 countries: supportive supervision and mentoring, data use for decision making, and EIR.28–30 A distinguishing feature of phase 2 was the role of the Alliance for Health Policy and Systems Research (AHPSR) as an AHI partner and source of technical support to partnerships on the use of EIR. Accordingly, the supplement includes original articles on the AHPSR work in the 3 countries. From the AHPSR, Tangcharoensathien et al. also contribute a comparative piece that reflects upon the status of health policy and systems research capacity in Ethiopia and Ghana.31

The Ethiopia Data Use Partnership shares valuable learnings from their efforts to increase the quality and use of routine health data. Belay et al. present findings from preproject and midline data use assessments, which point to early-stage successes and challenges in strengthening routine health information systems at the point of care and the district level.32 Tilahun et al.’s qualitative exploration of strategies and barriers to improving the quality and use of routine data in the same settings contextualize those findings. Together, the articles yield a rich picture of the factors that underpinned early program achievements and how evidence informs strategy to improve data-use practices during the later stages of the program.33 Worku et al. explored whether there were preproject associations between the strength of routine health information systems and maternal health care seeking.34 The findings suggest patterns and frame hypotheses that Ethiopia Data Use Partnership researchers will explore at later stages of their program.

From Ghana, Awoonor-Williams et al. narrate twin histories of research utilization to inform UHC policy, comparing Ghana’s experience scaling up the national Community-based Health Planning and Services program and the National Health Insurance Scheme.27 Bawah et al. explore the barriers and facilitators to evidence use in policy decision making in Ghana.35 Both articles provide insight on how to use the EIR approach to improve the country’s UHC policy coverage and effectiveness.

From Mozambique, learnings emerged on improving management, its association with resiliency, and ongoing challenges of research use to drive needed policy. Pope et al. explore whether facility-level management capacities are associated with facilities’ readiness to provide family planning services.36 The findings underscore the relevance of targeting leadership structures at the facility and district level with management capacity strengthening. Inguane et al. report on lessons from embedding qualitative research in the early-stage implementation of a district-level audit and feedback strategy.8 Fernandes et al. performed an analysis of routine health data from 4 districts in Central Mozambique, reflecting the periods before and after Cyclone Idai in 2019.37 The analysis demonstrates a rapid rebound of service utilization levels in the cyclone’s aftermath, which suggests that the AHI’s investment in strengthening district management systems had a positive effect on health systems resiliency after a devastating shock. From the AHPSR, Cambe et al. illustrate the challenging context of supporting research utilization in policy contexts.38

The supplement concludes with perspective pieces issued by thought leaders in EIR and pri-mary health care strengthening. In their commentary, Ghaffar et al. of the AHPSR situate the findings reported in the collection of articles in the historical context in which implementation research and embedded science converged and evolved together over time.39 Binagwaho et al. from the University of Global Health Equity discuss the role of implementation research in establishing resilient health systems, drawing upon the authors’ experiences in Rwanda and examples from other countries.40

CONCLUSION

The publication of this supplement marks a milestone in the history of the AHI and the application of implementation research in global public health. The learnings compiled in the 3 AHI collections reflect the evolution of a discipline that was relatively new to the primary health care landscape in sub-Saharan Africa when the AHI began but is now increasingly recognized as integral to health systems development. The results described in this supplement will be valuable to policy makers, researchers, and implementation teams that desire to maximize the impact of EBI through EIR and establish a culture of learning and improving in health systems. Disseminating this knowledge and supporting efforts to translate it into practice are urgently needed to hasten countries’ achievement of universal access to quality and people-centered primary health care.

Acknowledgments

The authors wish to recognize the Ministries of Health of Ethiopia, Ghana, and Mozambique, as well as implementation teams from the local health systems in which the African Health Initiative (AHI) partnerships worked, for their leadership and commitment to the work that is described in this supplement. Their support was essential to the achievements of the AHI during both its phases and for this we extend our gratitude.

Funding

The Doris Duke Charitable Foundation.

Competing interests

None declared.

Notes

Cite this article as: Baynes C, Adedokun L, Awoonor-Williams JK, et al. Learning health systems to bridge the evidence-policy-practice gap in primary health care: lessons from the African Health Initiative. Glob Health Sci Pract. 2022;10(Suppl 1):e2200390. https://doi.org/10.9745/GHSP-D-22-00390

  • Received: August 25, 2022.
  • Accepted: August 25, 2022.
  • Published: September 15, 2022.
  • © Baynes et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-22-00390

REFERENCES

  1. 1.↵
    1. Sheikh K,
    2. Hargreaves J,
    3. Khan M,
    4. Mounier-Jack S
    . Implementation research in LMICs—evolution through innovation. Health Policy Plan. 2020;35(Suppl 2):ii1–ii3. doi:10.1093/heapol/czaa118. pmid:33156932
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Theobald S,
    2. Brandes N,
    3. Gyapong M,
    4. et al
    . Implementation research: new imperatives and opportunities in global health. Lancet. 2018;392(10160):2214–2228. doi:10.1016/s0140-6736(18)32205-0. pmid:30314860
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Jackson D,
    2. Shahabuddin ASM,
    3. Sharkey AB,
    4. et al
    . Closing the know-do gap for child health: UNICEF’s experiences from embedding implementation research in child health and nutrition programming. Implement Sci Commun. 2021;2(1):112. doi:10.1186/s43058-021-00207-9. pmid:34588002
    OpenUrlCrossRefPubMed
  4. 4.↵
    1. Ridde V
    . Need for more and better implementation science in global health. BMJ Glob Health. 2016;1(2):e000115. doi:10.1136/bmjgh-2016-000115. pmid:28588947
    OpenUrlFREE Full Text
  5. 5.↵
    1. Awoonor-Williams JK,
    2. Appiah-Denkyira E
    . Bridging the intervention-implementation gap in primary health care delivery: the critical role of integrated implementation research. BMC Health Serv Res. 2017;17(Suppl 3):772. doi:10.1186/s12913-017-2663-8. pmid:29297396
    OpenUrlCrossRefPubMed
  6. 6.↵
    1. Leeman J,
    2. Birken SA,
    3. Powell BJ,
    4. Rohweder C,
    5. Shea CM
    . Beyond “implementation strategies”: classifying the full range of strategies used in implementation science and practice. Implement Sci. 2017;12(1):125. doi:10.1186/s13012-017-0657-x. pmid:29100551
    OpenUrlCrossRefPubMed
  7. 7.↵
    1. Wensing M,
    2. Grol R
    . Knowledge translation in health: how implementation science could contribute more. BMC Med. 2019;17(1):88. doi:10.1186/s12916-019-1322-9. pmid:31064388
    OpenUrlCrossRefPubMed
  8. 8.↵
    1. Inguane C,
    2. Soi C,
    3. Gimbel S,
    4. et al
    . Applying the Consolidated Framework for Implementation Research to identify implementation determinants for the Integrated District Evidence-to-Action Program Mozambique. Glob Health Sci Pract. 2022;10(Suppl 1):e2100714. doi:10.9745/GHSP-D-21-00714
    OpenUrlAbstract/FREE Full Text
  9. 9.↵
    1. Varallyay NI,
    2. Langlois E v,
    3. Tran N,
    4. Elias V,
    5. Reveiz L
    . Health system decision-makers at the helm of implementation research: development of a framework to evaluate the processes and effectiveness of embedded approaches. Health Res Policy Syst. 2020;18(1). doi:10.1186/s12961-020-00579-9. pmid:32522238
    OpenUrlCrossRefPubMed
  10. 10.↵
    1. Ghaffar A,
    2. Langlois E v, Rasanathan K,
    3. Peterson S,
    4. Adedokun L,
    5. Tran NT
    . Strengthening health systems through embedded research. Bull World Health Organ. 2017;95(2). doi:10.2471/BLT.16.189126. pmid:28250505
    OpenUrlCrossRefPubMed
  11. 11.↵
    1. Gilson L
    . Implementing health system change: what are the lessons from the African Health Initiative? BMC Health Serv Res. 2013;13(Suppl 2):S14. doi:10.1186/1472-6963-13-s2-s14. pmid:23819897
    OpenUrlCrossRefPubMed
  12. 12.
    1. Mutale W,
    2. Chintu N,
    3. Amoroso C,
    4. et al
    . Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative. BMC Health Serv Res. 2013;13(Suppl 2):S9. doi:10.1186/1472-6963-13-s2-s9. pmid:23819699
    OpenUrlCrossRefPubMed
  13. 13.
    1. Hirschhorn LR,
    2. Baynes C,
    3. Sherr K,
    4. et al
    . Approaches to ensuring and improving quality in the context of health system strengthening: a cross-site analysis of the five African Health Initiative Partnership programs. BMC Health Serv Res. 2013;13(Suppl 2):S8. doi:10.1186/1472-6963-13-s2-s8. pmid:23819662
    OpenUrlCrossRefPubMed
  14. 14.
    1. Sherr K,
    2. Requejo JH,
    3. Basinga P
    . Implementation research to catalyze advances in health systems strengthening in sub-Saharan Africa: the African Health Initiative. BMC Health Serv Res. 2013;13(Suppl 2):S1. doi:10.1186/1472-6963-13-s2-s1. pmid:23819761
    OpenUrlCrossRefPubMed
  15. 15.↵
    1. Bryce J,
    2. Requejo JH,
    3. Moulton LH,
    4. Ram M,
    5. Black RE
    . Collaborative PHI and T– AHID. A common evaluation framework for the African Health Initiative. BMC Health Serv Res. 2013;13(Suppl 2):S10. doi:10.1186/1472-6963-13-s2-s10. pmid:23819778
    OpenUrlCrossRefPubMed
  16. 16.↵
    1. Awoonor-Williams JK,
    2. Phillips JF,
    3. Bawah AA
    . Catalyzing the scale-up of community-based primary healthcare in a rural impoverished region of northern Ghana. Int J Health Plann Manage. 2016;31(4):e273–e289. doi:10.1002/hpm.2304. pmid:26189569
    OpenUrlCrossRefPubMed
  17. 17.↵
    1. Sherr K,
    2. Cuembelo F,
    3. Michel C,
    4. et al
    . Strengthening integrated primary health care in Sofala, Mozambique. BMC Health Serv Res. 2013;13(Suppl 2):S4. doi:10.1186/1472-6963-13-s2-s4. pmid:23819552
    OpenUrlCrossRefPubMed
  18. 18.↵
    1. Magge H,
    2. Nahimana E,
    3. Mugunga JC,
    4. et al
    . The All Babies Count initiative: impact of a health system improvement approach on neonatal care and outcomes in Rwanda. Glob Health Sci Pract. 2020;8(3):0. doi:10.9745/ghsp-d-20-00031. pmid:33008847
    OpenUrlAbstract/FREE Full Text
  19. 19.↵
    1. Ramsey K,
    2. Hingora A,
    3. Kante M,
    4. et al
    . The Tanzania Connect Project: a cluster-randomized trial of the child survival impact of adding paid community health workers to an existing facility-focused health system. BMC Health Serv Res. 2013;13(S2):S6. doi:10.1186/1472-6963-13-s2-s6. pmid:23819587
    OpenUrlCrossRefPubMed
  20. 20.↵
    1. Magge H,
    2. Chilengi R,
    3. Jackson EF,
    4. et al
    . Tackling the hard problems: Implementation experience and lessons learned in newborn health from the African Health Initiative. BMC Health Serv Res. 2017;17(Suppl 3):829. doi:10.1186/s12913-017-2659-4. pmid:29297352
    OpenUrlCrossRefPubMed
  21. 21.
    1. Sherr K,
    2. Fernandes Q,
    3. Kanté AM,
    4. et al
    . Measuring health systems strength and its impact: experiences from the African Health Initiative. BMC Health Serv Res. 2017;17(Suppl 3):827. doi:10.1186/s12913-017-2658-5. pmid:29297341
    OpenUrlCrossRefPubMed
  22. 22.
    1. Gimbel S,
    2. Mwanza M,
    3. Nisingizwe MP,
    4. Michel C,
    5. Hirschhorn L
    . Improving data quality across 3 sub-Saharan African countries using the Consolidated Framework for Implementation Research (CFIR): results from the African Health Initiative. BMC Health Serv Res. 2017;17(Suppl 3):828. doi:10.1186/s12913-017-2660-y. pmid:29297401
    OpenUrlCrossRefPubMed
  23. 23.
    1. Manzi A,
    2. Hirschhorn LR,
    3. Sherr K,
    4. Chirwa C,
    5. Baynes C,
    6. Awoonor-Williams JK
    . Mentorship and coaching to support strengthening healthcare systems: lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa. BMC Health Serv Res. 2017;17(Suppl 3):831. doi:10.1186/s12913-017-2656-7. pmid:29297323
    OpenUrlCrossRefPubMed
  24. 24.
    1. Rwabukwisi FC,
    2. Bawah AA,
    3. Gimbel S,
    4. et al
    . Health system strengthening: a qualitative evaluation of implementation experience and lessons learned across five African countries. BMC Health Serv Res. 2017;17(Suppl 3):826. doi:10.1186/s12913-017-2662-9. pmid:29297333
    OpenUrlCrossRefPubMed
  25. 25.
    1. Wagenaar BH,
    2. Hirschhorn LR,
    3. Henley C,
    4. et al
    . Data-driven quality improvement in low-and middle-income country health systems: lessons from seven years of implementation experience across Mozambique, Rwanda, and Zambia. BMC Health Serv Res. 2017;17. doi:10.1186/s12913-017-2661-x. pmid:29297319
    OpenUrlCrossRefPubMed
  26. 26.↵
    1. Hedt-Gauthier BL,
    2. Chilengi R,
    3. Jackson E,
    4. et al
    . Research capacity building integrated into PHIT projects: leveraging research and research funding to build national capacity. BMC Health Serv Res. 2017;17. doi:10.1186/s12913-017-2657-6. pmid:29297405
    OpenUrlCrossRefPubMed
  27. 27.↵
    1. Awoonor-Williams JK,
    2. Apanga S,
    3. Bawah AA,
    4. et al
    . Using health systems and policy research to achieve universal health coverage in Ghana. Glob Health Sci Pract. 2022;10(4)(Suppl 1):e2100763. doi:10.9745/GHSP-D-21-00763
    OpenUrlAbstract/FREE Full Text
  28. 28.↵
    African Health Initiative Partnership Collaborative for Supportive Supervision and Mentoring. Improving primary care quality through supportive supervision and mentoring: lessons from the African Health Initiative in Ethiopia, Ghana, and Mozambique. Glob Health Sci Pract. 2022;10(Suppl 1):e2100667. doi:10.9745/GHSP-D-21-00667
    OpenUrlAbstract/FREE Full Text
  29. 29.
    African Health Initiative Partnership Collaborative for Data Use for Decision Making. Barriers and facilitators to data use for decision making: the experience of the African Health Initiative partnerships in Ethiopia, Ghana, and Mozambique. Glob Health Sci Pract. 2022;10(Suppl 1):e2100666. doi:10.9745/GHSP-D-21-00666
    OpenUrlAbstract/FREE Full Text
  30. 30.↵
    African Health Initiative Partnership Collaborative for Embedded Implementation Research. Embedding research on implementation of primary health care systems strengthening: a commentary on collaborative experiences in Ethiopia, Ghana, and Mozambique. Glob Health Sci Pract. 2022;10(Suppl 1):e2200061. doi:10.9745/GHSP-D-22-00061
    OpenUrlAbstract/FREE Full Text
  31. 31.↵
    1. Tangcharoensathien V,
    2. Sudhakar M,
    3. Birhanu Z,
    4. et al
    . Capacities for health policy and systems research in Ethiopia and Ghana: findings from a self-assessment. Glob Health Sci Pract. 2022;10(Suppl 1): e2100715. doi:10.9745/GHSP-D-21-00715
    OpenUrlAbstract/FREE Full Text
  32. 32.↵
    1. Belay H,
    2. Mohammedsanni A,
    3. Gebeyehu A,
    4. et al
    . Lessons learned from the Capacity-Building and Mentorship Program to improve health information systems in 11 districts of Ethiopia. Glob Health Sci Pract. 2022;10(Suppl 1):e2100690. doi:10.9745/GHSP-D-21-00690
    OpenUrlAbstract/FREE Full Text
  33. 33.↵
    1. Tilahun H,
    2. Abate B,
    3. Belay H,
    4. et al
    . Drivers and barriers to improved data quality and data-use practices: an interpretative qualitative study in Addis Ababa, Ethiopia. Glob Health Sci Pract. 2022;10(Suppl 1):e2100689. doi:10.9745/GHSP-D-21-00689
    OpenUrlAbstract/FREE Full Text
  34. 34.↵
    1. Worku AG,
    2. Tilahun HA,
    3. Belay HT,
    4. et al
    . Maternal service coverage and its relationship to health information system performance: a linked facility and population-based survey in Ethiopia. Glob Health Sci Pract. 2022;10(Suppl Supplement_1):e2100688. doi:10.9745/GHSP-D-21-00688
    OpenUrlAbstract/FREE Full Text
  35. 35.↵
    1. Bawah AA,
    2. Biney AAE,
    3. Kyei P
    . “You can’t look at an orange and draw a banana”: using research evidence to develop relevant health policy in Ghana. Glob Health Sci Pract. 2022;10(Suppl 1):e2100693. doi:10.9745/GHSP-D-21-00693
    OpenUrlAbstract/FREE Full Text
  36. 36.↵
    1. Pope S,
    2. Augusto O,
    3. Fernandes Q,
    4. et al
    . Primary health care management effectiveness as a driver of family planning service readiness: a cross-sectional analysis in central Mozambique. Glob Health Sci Pract. 2022;10(Suppl 1):e2100706. doi:10.9745/GHSP-D-21-00706
    OpenUrlAbstract/FREE Full Text
  37. 37.↵
    1. Fernandes Q,
    2. Augusto O,
    3. Chicumbe S,
    4. et al
    . Maternal and child health care service disruptions and recovery in Mozambique after Cyclone Idai: an uncontrolled interrupted time series analysis. Glob Health Sci Pract. 2022;10(Suppl 1):e2100796. doi:10.9745/GHSP-D-21-00796
    OpenUrlAbstract/FREE Full Text
  38. 38.↵
    1. Cambe MI,
    2. Botão C,
    3. Dulá J,
    4. et al
    . The use of research for health systems policy development and implementation in Mozambique: a descriptive study. Glob Health Sci Pract. 2022;10(Suppl 1):e2100694. doi:10.9745/GHSP-D-21-00694
    OpenUrlAbstract/FREE Full Text
  39. 39.↵
    1. Ghaffar A,
    2. Dal Zennaro L,
    3. Tran N
    . African Health Initiative’s role in advancing the use of embedded implementation research for health systems strengthening. Glob Health Sci Pract. 2022;10(Suppl 1):e2200318. doi:10.9745/GHSP-D-22-00318
    OpenUrlFREE Full Text
  40. 40.↵
    1. Binagwaho A,
    2. Hirwe D,
    3. Mathewos K
    . Health system resilience: withstanding shocks and maintaining progress. Glob Health Sci Pract. 2022;10(Suppl 1):e2200076. doi:10.9745/GHSP-D-22-00076
    OpenUrlFREE Full Text
PreviousNext
Back to top

In this issue

Global Health: Science and Practice: 10 (Supplement 1)
Global Health: Science and Practice
Vol. 10, No. Supplement 1
September 15, 2022
  • Table of Contents
  • About the Cover
  • Index by Author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Global Health: Science and Practice.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative
(Your Name) has forwarded a page to you from Global Health: Science and Practice
(Your Name) thought you would like to see this page from the Global Health: Science and Practice web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative
Colin Baynes, Lola Adedokun, John Koku Awoonor-Williams, Lisa R. Hirschhorn
Global Health: Science and Practice Sep 2022, 10 (Supplement 1) e2200390; DOI: 10.9745/GHSP-D-22-00390

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative
Colin Baynes, Lola Adedokun, John Koku Awoonor-Williams, Lisa R. Hirschhorn
Global Health: Science and Practice Sep 2022, 10 (Supplement 1) e2200390; DOI: 10.9745/GHSP-D-22-00390
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Statistics from Altmetric.com

Jump to section

  • Article
    • INTRODUCTION
    • AHI’S HISTORY OF LEVERAGING EIR TO STRENGTHEN POLICY AND PRACTICE
    • HELPING PRIMARY HEALTH CARE SYSTEMS BRIDGE THE KNOW-DO GAP
    • CONCLUSION
    • Acknowledgments
    • Funding
    • Competing interests
    • Notes
    • REFERENCES
  • Info & Metrics
  • Comments
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • The Supply Chain Workforce: The Foundation of Health Supply Chains
  • The Challenge Initiative: Lessons on Rapid Scale-Up of Family Planning and Adolescent and Youth Sexual and Reproductive Health Services
  • Low-Dose Antenatal Calcium Supplementation: An Intervention Ready for Prime Time
Show more EDITORIAL

Similar Articles

Subjects

  • Cross-Cutting Topics
    • Health Systems
Johns Hopkins Center for Communication Programs

Follow Us On

  • LinkedIn
  • Facebook
  • RSS

Articles

  • Current Issue
  • Advance Access Articles
  • Past Issues
  • Topic Collections
  • Most Read Articles
  • Supplements

More Information

  • Submit a Paper
  • Instructions for Authors
  • Instructions for Reviewers

About

  • About GHSP
  • Advisory Board
  • FAQs
  • Privacy Policy
  • Contact Us

© 2025 Creative Commons Attribution 4.0 International License. ISSN: 2169-575X

Powered by HighWire